In recent years, the American College of Radiology (ACR) has expanded its federal government relations staff to deal with the congress and the federal bureaucracies. The ACR also created a political action committee that raised money from radiologists and spread it among political candidates. It has been 46 years since the ACR gulped hard at the draft language for Medicare and made a bold decision to fight for the status of radiology in a program that began consideration only as a hospital compensation package.
In the early 1960s, the ACR and most other national specialty societies were located in Chicago, clustered around the headquarters of the American Medical Association (AMA). When issues about medicine or about elements dealing with a specialty arose in the federal government, the ACR and most of the other specialty groups turned to the AMA for its Washington office to help resolve the problem.
All of this was before the advent of Medicare. That triggered an imperative for most specialties to get their own Washington presence and lobby for congressional favoritism and against prejudice.
There had been proposals for federal payment for health services since the 1930s, when the Democratic New Deal was recovering from the economic depression. But none of the proposals got any political support. The Medicare effort started in 1960, with the election of President John F. Kennedy, Vice President Lyndon Johnson, and a strong Democratic majority in Congress. The AMA had continued to oppose any programs for government regulation and payment for medical services. But the American Hospital Association (AHA) had chosen to push for a system to pay for hospital services.
With considerable concern about any scheme for all of us, the draft legislation was written to pay for services to elderly Social Security beneficiaries and covering only hospital costs. The challenge for radiology was that the draft bill included payment to hospitals for radiology, pathology, and anesthesiology professional services and no payment to physicians. Also, there was no payment for physician services in private offices. This would have been destructive to maintaining radiology offices and put radiologists at the compensation dictation of hospital administrations.
The AMA was opposed to any version of Medicare and could not take on the details about hospital coverage of radiology, pathology, and anesthesiology. So, all three of the societies decided to fight the problems for themselves. That meant hiring their own lobbyist. The ACR choice was J. T. “Slick” Rutherford, a former Democratic Texas congressman who was close to President Johnson, House Speaker Sam Rayburn, and the chairman of the House Ways and Means Committee, Wilbur Mills, who would draft the final version of a Medicare bill.
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